Growing Health Together: Connecting communities and primary care to reduce health inequalities

Summary  

Growing Health Together is a Surrey Heartlands Integrated Care System (ICS) initiative that connects GPs with local communities to improve health and reduce inequalities through place-based partnerships. The project has successfully improved wellbeing for citizens, strengthened community organisations, and enabled more proactive primary care while demonstrating how joined-up working can effectively address broader health challenges. 

Challenge  

Health inequalities in England are at a critical point, with a stark 10-year gap in life expectancy between the most and least deprived areas. The government has identified a crucial need to shift from treatment to prevention and deliver care closer to communities to reduce inequalities and create a more sustainable NHS. However, ICSs may need support to determine which interventions will effectively reallocate resources from acute to primary and community care settings.  

Surrey Heartlands ICS is tackling this challenge through a project called Growing Health Together (GHT). In December 2020, GHT was invited to assist groups of GP surgeries called Primary Care Networks (PCNs), to collaborate with community members and local organisations to improve health and prevent disease across East Surrey.  

The approach 

GHT was established in response to recognising the need to forge connections between general practice and local neighbourhoods. GHT is hosted by Alliance for Better Care. GHT uses a place-based partnership approach to generate community solutions that improve health and reduce health inequalities.  

GHT prioritises partnership between GPs, local organisations, communities and residents to co-create an environment where health is improved. All five PCNs in East Surrey engaged with GHT, and initiatives developed in each place reflect the needs of the local community and the resources in the area.  

Evaluating impact of GHT 

An evaluation of GHT was undertaken by the Centre for Health Services Studies research team at the University of Kent to understand its implementation and impact. This work was funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Kent, Surrey and Sussex (ARC KSS) and supported by Health Innovation Kent Surrey Sussex (KSS). 

Three case study sites were selected, including Horley, Redhill and South Tandridge. The evaluation used a mixed-methods approach and sourced data and insights from interviews, online questionnaires, observation field notes, and document analysis. The evaluation sought feedback from a wide range of stakeholders involved in the project, including professionals and citizens.  

Findings  

Health and care system impact 

The GHT model was found to benefit GPs and primary care, local authorities, borough and county councils. 

For GPs and primary care professionals, GHT enabled more proactive patient care and better prevention, while helping balance patient engagement – reducing frequent visits from some while encouraging attendance from harder-to-reach groups. Staff reported improved job satisfaction and retention. 

GHT helped to address broader local challenges, including housing, homelessness, antisocial behaviour, drug and substance misuse, and other prevention activities. GHT was seen to reduce reliance on social care and improve public health. Participants in the programme reported that GHT put the citizen voice at the centre of service delivery and demonstrated how joined-up working could happen in practice.  

Impact on citizens and community organisations  

The evaluation revealed positive impacts across citizens and community organisations.  

Citizens reported improved wellbeing, skills, and social connections, with one member noting, “It has made a huge difference. Just chatting to people again. You realise you’re not alone.”  

Community organisations benefited from increased social capital, wider networks, better local knowledge, and stronger partnerships with professionals including GPs. 

Core themes and supporting wider rollout  

The evaluation reveals “connections” as the golden thread running through all domains of the GHT project – from reaching diverse communities to ensuring sustainability.  

Researchers have developed an implementation model for how place-based collaborations involving NHS partners, such as GHT, can successfully contribute to local conditions for health creation. Accompanying this model is a set of recommendations across three phases that NHS partners can use to guide implementation in local areas. The model emphasises the critical role of connections, relationships and people in creating successful place-based health initiatives. 

Sam Fraser, Implementation Lead, Primary and Community Health Services at Health Innovation KSS, said: “Growing Health Together in East Surrey Primary Care is a vital initiative because it fosters a collaborative approach to health promotion, empowering individuals and communities to take control of their health. By addressing the prevention agenda, it enables proactive, sustainable change that reduces health inequalities and enhances overall well-being, ensuring that care is focused on long-term health outcomes rather than just treating illness. I am pleased that ARC KSS has recognised the value of Growing Health Together and been able to fund an evaluation of the initiative, helping us to better understand how it works and to build the evidence base needed to ensure impact and scalability”. 

Find out more   

Read the full evaluation here. 

Visit the Growing Health Together website here: Growing Health Together   

Acknowledgements  

Thank you to the following stakeholders involved in the design and delivery of this project: 

• Katherine Saunders, Alliance for Better Care CEO 

• Dr Gillian Orrow, GP & Director and Amanda Johnlewis, programme manager, Growing Health Together 

• Dr Sarah Hotham, Sharon Manship, Jenny Monkhouse, Erica Ferris. Centre for Health Services Studies (CHSS), University of Kent  

• ARC KSS team, Dr Sam Fraser (Health Innovation KSS), Professor Harm Van Marwijk, Dr Devyn Glass and Dr Deborah Ikhile  

• Public Advisory Group